Cancer remains a major cause of death in the UK. There are around 350,000 new cases of cancer diagnosed every year in the UK and around 160,000 are dying from cancer each year. It is thought that 38% of cases could be avoided.

Cancer research: Developing Areas

Research in the causes, diagnosis and treatment of cancer is a high priority and developments are being made all the time. The media regularly tell us about developments in cancer research and it is often difficult to work out which are significant and which are not.

Here are 4 areas of cutting edge research where there have been important recent developments and where we may expect to see more in the coming years.

1. Immunotherapy

Immunotherapy is sometimes called ‘biological therapy’. It aims to boost the body’s own defences to fight developing cancer. Immunotherapy can be effective for patients who are resistant to chemotherapy and radiotherapy. It is particularly helpful in treating lung cancer and lymphoma.

There are currently over 2,500 trials of immunotherapy worldwide. One of the issues research is addressing is why some patients respond well to immunotherapy whilst others do not.

2. Liquid biopsy tests

The aim of liquid biopsy tests is to diagnose cancer by blood tests – more simply, quickly and cheaply than at present. Blood samples can provide a lot of information about the make-up of a cancer. It is much less invasive that tissue biopsies where a sample of the tumour itself has to be removed and can then be examined under the microscope.

The hope is that liquid biopsy may be a quicker, simpler and cheaper way of detecting cancer and understanding its nature. It may also be possible in time to monitor how tumours respond to treatment and if and when the tumour recurs. This is a very complex area. There is a large body of research being done at present.

3. Microbiome

We all have a large number of bacteria in our own body. They protect us from disease, break down food and produce energy. Some can also cause us harm. The microbiome is the term for the ecosystem each of us has within.

Some recent research suggests that the flora (the community of bacteria) in our digestive tract may be affects conditions such as multiple sclerosis, inflammatory bowel disease and Alzheimer’s. Recently some cancer research has suggested that the microbiome can have an impact on how we respond to chemotherapy. In particular it is possible that our gut-flora could play a role when people develop multiple myeloma, an incurable cancer. The hope is that medication affecting these bacteria could slow the disease.

4. Organoids

Organoids are tiny tissue cultures grown in the laboratory from stem cells. Cells are taken from a patient’s organ and then used to grow miniature replica organs. When treated with cancer medications, those tiny replicas may respond in the same way the patient’s organ will. This is a way to test whether particular drugs will be effective for this particular patient. In effect organoids are a way to personalise cancer treatment to see what will work.

Organoids work best with certain types of tumours such as those in the lower digestive tract – the colon and rectum.

This sounds like science fiction but it is an interesting and developing area of research.

Cancer: Delays in Diagnosis

One area where, as lawyers working in this area, we have not seen much progress is avoiding errors in diagnosing cancer. NHS Resolution, which handles legal claims against NHS hospitals, plans to collate data about mistakes to work out how hospitals can learn from mistakes.

Here are 3 areas where, in our experience things go wrong.

1. Delays in referral by GP

The statistics suggest that we are not as good in the UK as our neighbours in Western Europe at diagnosing cancer early. This may not be the fault of the doctors. There may be cultural factors leading to patients presenting late. But we regularly see cases where family doctors fail to refer people for investigations when they should. NICE Guidelines are there to assist doctors to work out when to make referrals. Unfortunately we see many cases where GPs fail to follow those guidelines and patients are diagnosed late as a result.

2. Failing to carry out investigations

Another problem is doctors failing to carry out investigations when they should. For instance, breast cancer is diagnosed by a combination of clinical examination, radiology and biopsy. Bowel cancer is often diagnosed by camera investigations of the bowel – colonoscopy or sigmoidoscopy. There are cases when these investigations should be done and are not.

3. Misinterpreting investigations

A third common problem is doing the investigation but getting the results wrong. Recent cases include a woman whose MRI scan showed breast cancer but the MRI report failed to mention it, biopsy results for melanoma being misinterpreted and a colonoscopy failing to spot bowel cancer.

There is some cutting edge research into cancer. We can only marvel at the science behind it. Hopefully this will improve our understanding of the disease. However as lawyers acting for patients whose cancer has been diagnosed late, it is disappointing to see some of the same errors being repeated. We need to understand why avoidable errors keep occurring and improve systems to make them less likely.